Immunoradiotherapy for NSCLC: mechanisms, clinical outcomes, and future directions

• Published in: Clinical & translational oncology Vol. 26; no. 5; pp. 1063 - 1076
• Main Authors: Weishan, He, Donglin, Zheng, Guangmei, Deng, Wenya, Liu, Fasheng, Wu, Jibing, Chen
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.05.2024
• Subjects: Medicine; Medicine & Public Health; Oncology; Review Article; Immunoradiotherapy; Non-small-cell lung cancer; Immune checkpoint inhibitor; Radiotherapy; Immunotherapy
• ISSN: 1699-3055; 1699-3055
• DOI: 10.1007/s12094-023-03337-9

Non-small-cell lung cancer (NSCLC) has an extremely low 5-year survival rate, with the only effective treatment being immunoradiotherapy (iRT). Here, we review the progress of clinical research on iRT for non-small-cell lung cancer (NSCLC) over 2018–2023, as well as the future directions. We first discuss the synergistic mechanisms of iRT, reflected in three aspects: immune regulation of RT, RT-activated immune-related pathways, and RT-related immune sensitization. iRT may include either external-beam or stereotactic-body RT combined with either immune checkpoint inhibitors (e.g., immunoglobulins against immune programmed cell death (PD) 1/PD ligand 1 or CD8 + T lymphocyte antigen 4) or traditional Chinese medicine drugs. Regarding clinical effectiveness and safety, iRT increases overall and progression-free survival and tumor control rate among patients with NSCLC but without a considerable increase in toxicity risk. We finally discuss iRT challenges and future directions reported over 2018–2023.